Background Several studies have investigated the effect of non–vitamin K antagonist oral anticoagulants ( NOAC s) in atrial fibrillation ( AF ) patients with cancer, but the results remain controversial. Therefore, we conducted a meta‐analysis to compare the efficacy and safety of NOAC s versus warfarin in this population. Methods and Results We systematically searched the PubMed and Embase databases until February 16, 2019 for studies comparing the effect of NOAC s with warfarin in AF patients with cancer. Risk ratios ( RR s) with 95% CI s were extracted and pooled by a random‐effects model. Five studies involving 8908 NOAC s and 12 440 warfarin users were included. There were no significant associations between cancer status and risks of stroke or systemic embolism, major bleeding, or death in AF patients. Compared with warfarin, NOAC s were associated with decreased risks of stroke or systemic embolism ( RR , 0.52; 95% CI , 0.28–0.99), venous thromboembolism ( RR , 0.37, 95% CI , 0.22–0.63), and intracranial or gastrointestinal bleeding ( RR , 0.65; 95% CI , 0.42–0.98) and with borderline significant reductions in ischemic stroke ( RR , 0.63; 95% CI , 0.40–1.00) and major bleeding ( RR , 0.73; 95% CI , 0.53–1.00). In addition, risks of efficacy and safety outcomes of NOAC s versus warfarin were similar between AF patients with and without cancer. Conclusions In patients with AF and cancer, compared with warfarin, NOAC s had lower or similar rates of thromboembolic and bleeding events and posed a reduced risk of venous thromboembolism.
The aim of this study was to evaluate the association of the body mass index (BMI) categories with the risk of sudden cardiac death (SCD) in a systematic review and meta-analysis. We systematically searched the PubMed, Embase, and Cochrane Library databases up to February 2018 for all studies reporting an association between BMI and risk of SCD. Relative risks (RRs) and 95% confidence intervals (CIs) were extracted and pooled using a random effects model. A total of 10 studies involving 1,381,445 participants were included in the meta-analysis. Overall, compared with the risk level in normal-weight controls, being underweight was not associated with increased risk of
Although several studies have assessed the effect of non‐vitamin K antagonist oral anticoagulants (NOACs) relative to that of vitamin K antagonists (VKAs) in patients with left ventricular thrombus, the results remain controversial. Herein, a meta‐analysis was performed to compare the effectiveness and safety of NOACs versus VKAs for the treatment of left ventricular thrombus. We systematically searched the Cochrane Library, PubMed and Embase databases until November 2020 for studies that compared the effects of NOACs versus VKAs in patients with left ventricular thrombus. The treatment effects were expressed as odds ratios (ORs) with 95% confidence intervals (CIs) and pooled by a random‐effects model. Seven retrospective studies involving 865 patients with left ventricular thrombus (266 NOAC and 599 VKA users) were included. The pooled analysis suggested no difference in the rate of thrombus resolution between the NOAC and VKA groups (OR = 0.83, 95% CI 0.61–1.13). There were also no differences in the rates of stroke or systemic embolism (OR = 0.62, 95% CI 0.20–1.97), bleeding events (OR = 0.73, 95% CI 0.37–1.45), or all‐cause death (OR = 0.92, 95% CI 0.50–1.69) between patients treated with NOACs and those treated with VKAs. In addition, the rates of thrombus resolution, stroke or systemic embolism, bleeding events, and all‐cause death between NOAC‐ and warfarin‐treated patients were also similar. Our current evidence suggested that NOAC and VKA users had similar rates of thrombus resolution and clinical outcomes among patients with left ventricular thrombus. Further large‐scale prospective studies should confirm our results.
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